Question 1

A(n) _____ ensures that the patient will pay for services received if a referral is not documented in the time specified.

Accepted Answer

A)  referral waiver 
B)  guarantee waiver 
C)  documentation waiver 
D)  endorsement waiver 
A)  referral waiver 
B)  guarantee waiver 
C)  documentation waiver 
D)  endorsement waiver

Question 2

A coordination of benefits rule that is used to determine which plan is primary when a child has primary insurance under both parents plans is called ____.

Accepted Answer

A)  gender rule 
B)  the parents decide 
C)  the plan that has the lower copay 
D)  the plan that has the lowest deductible 
A)  gender rule 
B)  the parents decide 
C)  the plan that has the lower copay 
D)  the plan that has the lowest deductible

Question 3

When the physician or medical assistant reviews information with the patient during the visit, where is this documented?

Accepted Answer

A)  the process form 
B)  the insurance form 
C)  the practice form 
D)  the medical record 
A)  the process form 
B)  the insurance form 
C)  the practice form 
D)  the medical record

Question 4

NP is the abbreviation for ____.

Accepted Answer

A)  New Patient 
B)  No Procedure 
C)  New Insurance 
D)  No Dependent 
A)  New Patient 
B)  No Procedure 
C)  New Insurance 
D)  No Dependent

Question 5

What should take place if an insured patient's policy does not cover a planned service?

Accepted Answer

A)  medical assistant files a complaint with the insurance company 
B)  the patient applies for a new insurance policy 
C)  patients should be informed that the payer does not pay for the service and that they are responsible for the charges 
D)  the patient is referred to another medical facility 
A)  medical assistant files a complaint with the insurance company 
B)  the patient applies for a new insurance policy 
C)  patients should be informed that the payer does not pay for the service and that they are responsible for the charges 
D)  the patient is referred to another medical facility

Question 6

What is an authorization number given to the referred physician called?

Accepted Answer

A)  insurance referral number 
B)  referral number 
C)  physician number 
D)  authorization number 
A)  insurance referral number 
B)  referral number 
C)  physician number 
D)  authorization number

Question 7

A provider who agrees to provide medical services to a payer's policyholders according to a contract is called _____.

Accepted Answer

A)  nonPAR 
B)  PAR 
C)  CPT 
D)  ICD 
A)  nonPAR 
B)  PAR 
C)  CPT 
D)  ICD

Question 8

On a patient insurance card, the plan codes are used for ____.

Accepted Answer

A)  claims submissions when medical services are rendered out-of-state 
B)  claims submissions when medical services are rendered in the hospital 
C)  claims submissions for dependents 
D)  claims submissions when medical services are elective 
A)  claims submissions when medical services are rendered out-of-state 
B)  claims submissions when medical services are rendered in the hospital 
C)  claims submissions for dependents 
D)  claims submissions when medical services are elective

Question 9

The policyholder or subscriber to a health plan or policy is called ____.

Accepted Answer

A)  dependent 
B)  insured 
C)  underwriter 
D)  endorser 
A)  dependent 
B)  insured 
C)  underwriter 
D)  endorser

Question 10

An encounter form is also called a(n) ____.

Accepted Answer

A)  superbill 
B)  patient report 
C)  insurance record 
D)  data form 
A)  superbill 
B)  patient report 
C)  insurance record 
D)  data form

Question 11

A(n) ____ is a provider who does not join a particular health plan.

Accepted Answer

A)  nonparticipating provider 
B)  uninsured provider 
C)  participating provider 
D)  non partaking provider 
A)  nonparticipating provider 
B)  uninsured provider 
C)  participating provider 
D)  non partaking provider

Question 12

Third insurance plan is called ____.

Accepted Answer

A)  supplementary insurance 
B)  adjuvant insurance 
C)  tertiary insurance 
D)  subsidiary insurance 
A)  supplementary insurance 
B)  adjuvant insurance 
C)  tertiary insurance 
D)  subsidiary insurance

Question 13

To be paid for services, medical practices need to establish financial responsibility and the first step is ___.

Accepted Answer

A)  verify what provider the patient will be seeing 
B)  verify that the patient has paid his or her premium 
C)  verify patients eligibility for benefits 
D)  verify the patients chart number 
A)  verify what provider the patient will be seeing 
B)  verify that the patient has paid his or her premium 
C)  verify patients eligibility for benefits 
D)  verify the patients chart number

Question 14

When patients see a nonPAR, providers, they ____.

Accepted Answer

A)  receive a discount 
B)  pay more for these out-of-network visits 
C)  pay a lower copayment 
D)  lose his or her insurance 
A)  receive a discount 
B)  pay more for these out-of-network visits 
C)  pay a lower copayment 
D)  lose his or her insurance

Question 15

When determining a patients' primary insurance and the patient is also covered as a dependent under another insurance policy, which is the primary insurance plan?

Accepted Answer

A)  the parent's plan 
B)  the patient's plan 
C)  the plan that the patient chooses 
D)  the plan that the medical professional chooses 
A)  the parent's plan 
B)  the patient's plan 
C)  the plan that the patient chooses 
D)  the plan that the medical professional chooses

Question 16

Which health plan pays benefits first?

Accepted Answer

A)  primary insurance 
B)  principal plans 
C)  secondary plan 
D)  chief plan 
A)  primary insurance 
B)  principal plans 
C)  secondary plan 
D)  chief plan

Question 17

EP is the abbreviation for _____.

Accepted Answer

A)  Envisioned Patient 
B)  Established Patient 
C)  Expected Patient 
D)  Envisaged Patient 
A)  Envisioned Patient 
B)  Established Patient 
C)  Expected Patient 
D)  Envisaged Patient

Question 18

When an established patient shows up for his or her appointment, what is the most important question the front desk staff member should ask?

Accepted Answer

A)  if any pertinent personal or insurance information has changed 
B)  if the patient would like to schedule a follow up visit 
C)  where would the patient wants the results sent 
D)  where would the patient want the referral sent 
A)  if any pertinent personal or insurance information has changed 
B)  if the patient would like to schedule a follow up visit 
C)  where would the patient wants the results sent 
D)  where would the patient want the referral sent

Question 19

When health plan responds to an eligibility inquiry, it includes information. Which of the following is not a piece of information that would be included?

Accepted Answer

A)  trace number 
B)  benefit information 
C)  benefit units 
D)  SOAP number 
A)  trace number 
B)  benefit information 
C)  benefit units 
D)  SOAP number

Question 20

When determining a patient's primary insurance and the patient has two group policies, which one is the primary?

Accepted Answer

A)  the plan that has been in effect the longest period of time 
B)  the plan that has the lower co pay 
C)  the plan that has the highest premium 
D)  the plan that has lowest deductible 
A)  the plan that has been in effect the longest period of time 
B)  the plan that has the lower co pay 
C)  the plan that has the highest premium 
D)  the plan that has lowest deductible

A(n) _____ ensures that the patient will pay for services received if a referral is not documented in the time specified.

A coordination of benefits rule that is used to determine which plan is primary when a child has primary insurance under both parents plans is called ____.

When the physician or medical assistant reviews information with the patient during the visit, where is this documented?

NP is the abbreviation for ____.

What should take place if an insured patient's policy does not cover a planned service?

What is an authorization number given to the referred physician called?

A provider who agrees to provide medical services to a payer's policyholders according to a contract is called _____.

On a patient insurance card, the plan codes are used for ____.

The policyholder or subscriber to a health plan or policy is called ____.

An encounter form is also called a(n) ____.

A(n) ____ is a provider who does not join a particular health plan.

Third insurance plan is called ____.

To be paid for services, medical practices need to establish financial responsibility and the first step is ___.

When patients see a nonPAR, providers, they ____.

When determining a patients' primary insurance and the patient is also covered as a dependent under another insurance policy, which is the primary insurance plan?

Which health plan pays benefits first?

EP is the abbreviation for _____.

When an established patient shows up for his or her appointment, what is the most important question the front desk staff member should ask?

When health plan responds to an eligibility inquiry, it includes information. Which of the following is not a piece of information that would be included?

When determining a patient's primary insurance and the patient has two group policies, which one is the primary?

From Patient to Payment Understanding Medical Insurance

Electronic Health Records, HIPAA, and Hitech: Sharing and Protectin

Diagnostic Coding

Procedural Coding

Payment Methods and Checkout Procedures

Health Care Claim Preparation and Transmission

Private Payers/Blue Cross and Blue Shield

Medicare

Medicaid

Tricare and Champva

Workers Compensation and Automobile/Disability Insurance

Claim Processing, Payments, and Collections

Hospital Insurance

Filters

Exam 3: Patient Encounters and Billing Information

A(n) _____ ensures that the patient will pay for services received if a referral is not documented in the time specified.

A coordination of benefits rule that is used to determine which plan is primary when a child has primary insurance under both parents plans is called ____.

When the physician or medical assistant reviews information with the patient during the visit, where is this documented?

NP is the abbreviation for ____.

What should take place if an insured patient's policy does not cover a planned service?

What is an authorization number given to the referred physician called?

A provider who agrees to provide medical services to a payer's policyholders according to a contract is called _____.

On a patient insurance card, the plan codes are used for ____.

The policyholder or subscriber to a health plan or policy is called ____.

An encounter form is also called a(n) ____.

A(n) ____ is a provider who does not join a particular health plan.

Third insurance plan is called ____.

To be paid for services, medical practices need to establish financial responsibility and the first step is ___.

When patients see a nonPAR, providers, they ____.

When determining a patients' primary insurance and the patient is also covered as a dependent under another insurance policy, which is the primary insurance plan?

Which health plan pays benefits first?

EP is the abbreviation for _____.

When an established patient shows up for his or her appointment, what is the most important question the front desk staff member should ask?

When health plan responds to an eligibility inquiry, it includes information. Which of the following is not a piece of information that would be included?

When determining a patient's primary insurance and the patient has two group policies, which one is the primary?

From Patient to Payment Understanding Medical Insurance

Electronic Health Records, HIPAA, and Hitech: Sharing and Protectin

Diagnostic Coding

Procedural Coding

Payment Methods and Checkout Procedures

Health Care Claim Preparation and Transmission

Private Payers/Blue Cross and Blue Shield

Medicare

Medicaid

Tricare and Champva

Workers Compensation and Automobile/Disability Insurance

Claim Processing, Payments, and Collections

Hospital Insurance

Filters